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Juxtaglomerular Cell Tumor: Reviewing a Cryptic Cause of Surgically Correctable Hypertension

机译:肾小球细胞肿瘤:审查外科纠正高血压的隐秘原因。

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摘要

Juxtaglomerular cell tumor (JGCT), or reninoma, is a typically benign neoplasm generally affecting adolescents and young adults due to modified smooth muscle cells from the afferent arteriole of the juxtaglomerular apparatus. Patients experience symptoms related to hypertension and hypoka-lemia due to renin-secretion by the tumor. MRI, PET, CT, and renal vein catheterizations can be used to capture JGCTs, with laparoscopic ultrasonography being most cost-efective. Surgical removal is the best option for management; electrolyte imbalances are a potential complication which may be assuaged via pre-surgical administration of aliskiren, a renin inhibitor. Considering the vast etiology for hypertension and rarity of JGCT, the diagnosing physician must have a high index of suspicion for JGCT. Early recognition and management can help prevent cardiovascular or pregnancy complications and fatalities, vascular invasion and metastasis, improve quality of life, and limit socioeconomic liabilities. Herein we review the epidemiology, genetics, histopathol-ogy, clinical presentation, and management of this rare condition. The impact of genetics on prognosis warrant further research.
机译:肾小球细胞瘤(JGCT)或肾素瘤是典型的良性肿瘤,由于来自肾小球装置传入小动脉的平滑肌细胞修饰,通常会影响青少年和年轻人。患者会因肿瘤分泌肾素而出现与高血压和低血钾有关的症状。 MRI,PET,CT和肾静脉导管检查可用于捕获JGCT,而腹腔镜超声检查最具成本效益。手术切除是管理的最佳选择。电解质失衡是潜在的并发症,可以通过术前给予肾素抑制剂阿利吉仑来缓解。考虑到JGCT的高血压和稀有性的广泛病因,诊断医生必须高度怀疑JGCT。早期识别和管理可以帮助预防心血管或妊娠并发症和死亡,血管入侵和转移,改善生活质量并限制社会经济责任。在这里,我们回顾了这种罕见病的流行病学,遗传学,组织病理学,临床表现和管理。遗传学对预后的影响值得进一步研究。

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